Common Orthopaedic Injuries in Newborns Parents should know

Birth injuries in newborn babies are a common problem. Injuries to the bones, joints and nerves can occur during normal delivery. It happens because the child has to pass through a narrow vaginal canal. 

Newborns with too much weight and advanced gestational age are at a higher risk of orthopaedic injuries. These injuries can also occur because the baby is positioned awkwardly during birth. You can avoid many of these injuries by Caesarean delivery.

Causes of Birth Injuries

The child may suffer from birth injuries due to medical problems. It involves factors related to the mother or baby — or other factors.

Some causes of birth injuries include:

• Fetal health factors: If a fetus is born feet-first during a vaginal delivery, they may experience oxygen deprivation. The fetus also loses blood flow or develops an infection which increases the risk of a birth injury.

• Mother’s health factors: Maternal infection, diabetes obesity, or abnormal shape of the mother’s pelvis. These can make delivery difficult and increase the chances of birth injury.

• Vacuum-assisted delivery: Vacuum-assisted vaginal deliveries can lead to significant fetal morbidity. The child may suffer from scalp lacerations, cephalohematomas, subgaleal hematomas, intracranial haemorrhage, facial nerve palsies, hyperbilirubinemia, and retinal haemorrhage.

• Size of the baby: Birth injuries can also occur more frequently among larger-than-average babies. In cases where the baby’s head or body may be too large in relation to the mother’s pelvic area (Cephalopelvic disproportion) birth injuries may occur.

Even though there are many causes of a birth injury, some parents never know the exact reason why their child suffered a birth injury. Fortunately, most of these birth injuries can be resolved with simple treatments by a pediatric orthopedic doctor.

Some of the most common orthopaedic birth injuries in newborns include the following:

Clavicle Fractures

Clavicle fractures are the most common birth injury. The clavicle, also known as collar bone connects the chest to the shoulder. The usual symptom is a pain in the child’s fracture area because this injury does not cause any noticeable deformity.

Simple treatment methods like strapping the arm to the chest can heal the child’s injuries. Treatment procedure only takes a few weeks because bones heal quickly in babies.

Femur Fracture

Femur fracture or broken thigh bone occurs when there is an abnormal twist in the child’s leg during delivery. It is a rare injury and much less common than clavicle fractures. 

Symptoms include pain when the child moves or when you change their diapers. The child’s femur fracture can be treated using a Pavlik harness worn for about 4 weeks.

Brachial Plexus Injury

A brachial plexus injury occurs because of an injury to the baby’s brachial plexus. It is a network of nerves which connects the spinal cord to the child’s arms and hands. 

Brachial palsy is common in difficult deliveries. It happens if a baby’s shoulder gets stuck in the birth canal, and the doctor pulls hard on one arm to help the newborn come out of the birth canal.

Common causes include:

• The baby’s head, neck, or shoulders gets stuck in the delivery process

• The doctor tugs on a baby’s neck or head during a difficult birth

• Tugging on the baby’s feet in a feet-first (breech) delivery

The most common symptom of brachial palsy is when the baby cannot flex or rotate the injured arm. The seriousness of the injury depends on how severely the nerves are damaged. 

If the child’s nerves are only stretched or bruised, the injury heals over weeks or months. With the help of physical therapy, the child’s arm movement can be restored. 

More severe injuries, in which the nerves are torn, often lead to permanent nerve damage.

The child’s body develops rapidly and has an immense capacity to heal. Most newborns fully recover from such injuries requiring small or minor treatments.